A 27-year-old man who has testicular cancer is being admitted for a unilateral orchiectomy. The patient does not talk to his wife and speaks to the nurse only to answer the admission questions. Which action is best for the nurse to take?
a. Teach the patient and the wife that impotence is unlikely after unilateral orchiectomy.
b. Ask the patient if he has any questions or concerns about the diagnosis and treatment.
c. Document the patient's lack of communication on the chart and continue preoperative care.
d. Inform the patient's wife that concerns about sexual function are common with this diagnosis.
ANS: B
The initial action by the nurse should be assessment for any anxiety or questions about the surgery or postoperative care. The nurse should address the patient, not the spouse, when discussing the diagnosis and any possible concerns. Without further assessment of patient concerns, the nurse should not offer teaching about complications after orchiectomy. Documentation of the patient's lack of interaction is not an adequate nursing action in this situation.
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